Private certifier lodgement for amended
plans or to extend relevant period for
existing building approval
Planning & Environment
City Development
PO Box 5042 GOLD COAST MC QLD 9729
P: 5582 8184 F: 5596 3653
E: mail@goldcoast.qld.gov.au
W: cityofgoldcoast.com.au
Please use BLOCK LETTERS and complete all details in full
Privacy statement
Council of the City of Gold Coast (Council) is collecting your personal information in accordance with the Building Act 1975 in order to comply with
section 149(1). The information will only be used by authorised Council officers for the purpose of archiving and ensuring our records are accurate.
Your information will not be given to any other person or agency unless you have given us permission or we are required by law.
Applicant details

Clearly identify who is making the application; provide the full name of the individual or company.

If the applicant is a company, a contact person must be shown.
Name (individual or company)
Contact person (for companies)
Postal address
Primary phone
Alternative phone
Facsimile
Email
The applicant confirms that the property owner(s) have provided written consent to the making of this application (where
required per legislation)
Property details

The description must identify all land that is subject of the building approval, including land/easements over which
access is to be obtained.

All lot and plan details (e.g. SP/RP) that relate to this approval, must be as shown on title documents or a rates notice.

Multiple properties must be identified. Use a separate page if more than two properties.

If the plan is not registered by title, please also provide the proposed lot and plan details.
Lot number /s
Registered plan type and number/s
Property address/es
Nature of the request

Please see explanatory note on next page.

For existing building applications archived with the City, please insert the City building application reference
number.
Existing City application reference number
BLD
Approved amended plans for a building application (s86(2)(a)(b))
Private Certifier extension to the relevant period before a building approval lapses for a further ______ month/s /
year/s (s96)
Consultation with the City before extending relevant period, for a further ______ month/s / year/s (s97)
Provide details of the
modification (including extension
of the period if relevant)
Fees 2013-14
The fees for this application can be found on the last page of this form.
Office use only
Date received
Fee paid
Received by
Receipt number
Business partner name
Account number
Business partner number
AMS code
iSPOT# 32487829 v12
Last Updated 01/07/2015
(if applicable)
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Fees 2015-16
Fee name
Account number
Amount
Amended plans
96657
$ 75.00
Extension of Commencement or relevant period
96657
$ 75.00
These fees are in accordance with the City’s regulatory fees and non-regulatory charges. A copy of the City’s regulatory fees and
non-regulatory charges can be found on the City’s website cityofgoldcoast.com.au
Payment options

Business partner account (BP) – please complete details below

Cash, cheque or credit card at any of the City’s branch offices. For branch office locations and operating hours, please refer
to the City’s website cityofgoldcoast.com.au

Cheque or money order by post to City of Gold Coast, PO Box 5042, Gold Coast MC QLD 9729. Please ensure that you
provide adequate reference details or attachments to allow the cheque to be appropriately receipted.
Please be advised that payments by credit card will incur a surcharge of 0.60%.
Business partner name
Business partner number
Declaration
I declare that:
 The information provided in this form is complete and correct
 I have read the privacy notice
Signature
Date
Notes
About this form
This lodgement form must be completed for lodgement of all amended and first extension of
relevant period building approvals that have been assessed by a Private Certifier, and are to
be archived; also to lodge a request to the Local Government for a further extension of the
relevant period. Applicants must comply with the mandatory requirements under the relevant
legislation to provide sufficient and correct information for the Council of the City of Gold
Coast.
Nature of the request
Approved amended plans for a building application (s86(2)(a)(b))
Lodgement (archiving) of approved amended plans for a previous Private Certifier building
approval
Private Certifier extension to the relevant period before a building approval lapses
(s96)
Lodgement (archiving) of an approved extension to the relevant period issued by Private
Certifier for a previous Private Certifier building approval.
Private Certifier consultation with the City before extending relevant period, (s97)
Section 97(2) of the Building Act 1975 states “The Private Certifier may further extend the
period only if the Private Certifier has consulted with the local government.”
Lodgement (consultation) of a further extension of the relevant period.
iSPOT# 32487829 v12
Last Updated 01/07/2015
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